摘要
目的 探究磁共振脂肪抑制质子密度加权成像(MRI PDWI-FS)序列评估膝骨关节炎(KOA)病变程度的临床价值及意义。方法 选取2022年1月至2023年12月漯河医学高等专科学校第二附属医院收治的105例KOA患者,均行MRI PDWI-FS序列扫描,以关节镜检查结果作为金标准,分析MRI PDWI-FS序列对KOA软骨损伤分级、K-L分级标准的诊断价值。结果 K-L分级标准显示,105例KOA患者中初期23例,早期17例,中期37例,晚期28例;关节镜检查显示,105例KOA患者2B级损伤82个,占28.67%;3级损伤53个,占18.53%;MRI PDWI-FS序列检出1级损伤83个;2A级损伤64个;2B级损伤86个;3级损伤53个,PDWI-FS序列诊断KOA软骨损伤分级与关节镜检查的一致性较高,Kappa值=0.934,95%CI为0.866~1.002,P<0.001;MRI PDWI-FS序列检出初期21例,早期17例,中期38例,晚期29例,PDWI-FS序列诊断K-L分级标准与关节镜检查的一致性较高,Kappa值=0.856,95%CI为0.743~0.970,P<0.001。结论 MRI PDWI-FS序列可清晰显示关节软骨损伤病灶位置、范围、深度等信息,可有效评价软骨下骨组织挫伤、骨囊变等,有助于临床诊断患者病情程度、针对性制定治疗方案,临床应用价值较高。
Objective To investigate the clinical value and significance of magnetic resonance proton density weighted imaging with fat saturation(MRI PDWI-FS)sequences for assessing the extent of lesions in knee osteoarthritis(KOA).Methods One hundred and five KOA patients admitted to the Second Affiliated Hospital of Luohe Medical College from January 2022 to December 2023 were selected,and all of them were scanned with MRI PDWI-FS sequences,and the diagnostic value of MRI PDWI-FS sequences on the cartilage damage grading of KOA and the K-L grading criteria was analyzed with the results of arthroscopy as the gold standard.Results The K-L grading standard showed that among the 105 patients with KOA,23 cases were in the initial stage,17 cases were in the early stage,37 cases were in the middle stage,and 28 cases were in the late stage.Arthroscopy showed that 82 of the 105 patients with KOA had grade 2B injuries,accounting for 28.67%,53 had grade 3 injuries,accounting for 18.53%.MRI PDWI-FS sequence detected 83 grade 1 injuries,64 grade 2A injuries,86 grade 2B injuries,53 grade 3 injuries.The consistency between the KOA cartilage injury grading diagnosed by MRI PDWI-FS sequence and arthroscopy was high,with a Kappa value of 0.934 and a 95%CI of 0.866-1.002,P<0.001.The MRI PDWI-FS sequence detected 21 cases in the initial stage,17 cases in the early stage,38 cases in the middle stage,and 29 cases in the late stage.The consistency between the K-L grading standard and arthroscopy diagnosed by MRI PDWI-FS sequence was high,with a Kappa value of 0.856 and a 95%CI of 0.743-0.970,P<0.001.Conclusion MRI PDWI-FS sequence can clearly display the location,scope,depth and other information of articular cartilage injury lesions,and can effectively evaluate subchondral bone tissue contusion and bone cystic degeneration,which is helpful for clinical diagnosis of patients’disease degree and targeted treatment plan,and has high clinical application value.
作者
杨勇政
黄文亮
孙英杰
YANG Yongzheng;HUANG Wenliang;SUN Yingjie(Department of Imaging,the Second Affiliated Hospital of Luohe Medical College,Luohe 462000,China)
出处
《河南医学研究》
CAS
2024年第20期3798-3802,共5页
Henan Medical Research
基金
2020年河南省医学科技攻关计划联合共建项目(LHGJ20200884)。
关键词
膝骨关节炎
磁共振成像
脂肪抑制质子密度加权成像序列
病变程度
评估价值
一致性分析
knee osteoarthritis
magnetic resonance imaging
proton density weighted imaging with fat saturation
degree of lesion
appraised value
consistency analysis
